For the first time, an international group of researchers measured cancer survival rates in one city in Sub-Saharan Africa. Survival is disturbingly low, as shown by a study in Harare, Zimbabwe.

The study, published in the International Journal of Cancer, found that cancer patients in Harare are not likely to survive five years after diagnosis. Researchers followed a few thousand people who had been diagnosed with the 15 most common types of cancer, including skin, liver, cervical, and lung cancer.

Survival rates vary among those types, but even in the best case, a patient's chance of being alive after five years is only about 50 percent. The study also shows that black Zimbabweans have even lower survival rates than white Zimbaweans.

Study author Max Parkin of the International Agency for Research on Cancer in France, says this is one of the first studies of cancer survival in Africa. His group has just completed research in Uganda and the Gambia as well, showing similar results to the Zimbabwe cancer study.

Although the types of cancer are different from those in the United States and Europe, Dr. Parkin says cancer is no less a problem in Africa. For example, Zimbabweans have fewer cases of the kinds of cancer that are partly caused by eating fatty foods. At the same time, cervical cancer is more common in Zimbabwe than in the United States, where women are treated before the cancer can develop. A certain kind of skin cancer that accompanies AIDS, called Kaposi sarcoma, is also more widespread.

"So it's not a particularly rare disease; the types of cancer are different," Dr. Parkin said. "It's a neglected problem because there are a lot of other pressing health problems that are there and require urgent attention; AIDS in particular at the moment, maternal and child health, infectious diseases so that cancer sort of tends to get forgotten."

Dr. Parkin suggests a number of possible reasons for low cancer survival rates in Harare and the difference between black and white Zimbabweans. He does not think race itself is an issue, except as it relates to social class. He adds that wealthier people often have better access to cancer treatment, especially in countries where it is not widely available. He also says people do not seek treatment for cancer early enough.

"There's this problem of knowledge about cancer," Dr. Parkin said. "People are quite unaware of the disease so they come at a stage when it's completely untreatable. So probably a lot more can be done about that awareness of the public, trying to persuade people that if you feel something you should go and seek treatment. And then try to make treatment available for those early cases."

Dr. Parkin adds that the AIDS epidemic may also affect cancer survival, because cancer patients who also have AIDS are abnormally weak.